Neurocysticercosis is no longer a medical curiosity in the United States. Two hundred thirty-eight patients with neurocysticercosis were studied between 1981 and 1986 at the Los Angeles County-University of Southern California Medical Center, Los Angeles. Presenting signs and symptoms were protean--ranging from a single convulsion to coma and death. Fifty-one patients (21%) presented with an acute increase in intracranial pressure. There were 71 patients who ultimately required a shunting procedure or craniotomy. Presentation, diagnosis, management, and laboratory adjuncts (the role of cysticercosis titers and the electroencephalogram) are discussed. Mortality and morbidity can be reduced by maintaining a high degree of suspicion in populations at increased risk for cysticercosis.